MEDICARE: CAPITAL WOMENS CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1295554921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL WOMENS CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 81310
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44181-0310
Country	:	US
Telephone Number	:	301-340-8339
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 GLEN AVE STE 104
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21804-5256
Country	:	US
Telephone Number	:	410-543-9111
Fax Number	:	410-543-9115

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DAMON HOU
Credential	:	MD
Telephone Number	:	301-340-8339

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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